The Growing Role of Chatbots in Healthcare

They are not doctors (yet), but well-trained bots can get patients to engage more in their care, helping to close the $300 billion ‘adherence gap’ in taking pills and following orders, say experts at Earley Information Science roundtable

No one would confuse them with young interns or seasoned surgeons, but chatbots are becoming the newest addition to medical teams. Hospitals and other providers, as well as insurers, are starting to employ these digital workers to remind patients to take their medicine, to monitor life signs and to track mountains of data across patient groups that could produce breakthrough insights about diseases and treatments. Already, consumers can choose from among dozens of bots that provide “care” as soon as they are downloaded.

Help from the bots is critically needed – the lack of patient adherence to prescribed medications and to post-procedure instructions is putting tremendous strains on both providers and payers. Avoidable medical spending exceeds $300 billion a year, according to a recent study by CapGemini.

But for bots to become major players in closing the adherence gap, and to deliver on other health-care and cost-saving fronts, their human bosses have to understand their capabilities while also appreciating their limitations, according to a panel of artificial intelligence (AI) and knowledge management experts at an Executive Roundtable discussion hosted on April 12 by Earley Information Science Corp. (EIS), a leading consulting firm focused on organizing information for business impact.

The bots can greatly improve patient experience, the panelists said, and in the process improve adherence and outcomes. But the spread and acceptance of bots has been slowed by regulatory restrictions, insurance rules and privacy concerns that still have to be addressed, the experts added. And, they noted, because of AI’s limitations in understanding human language, the bots have to be seen as very junior members of the team, and a long way, if ever, from hanging out their own shingles.

Bots can enable meaningful conversations with the care team and with patients, and encourage better patient behavior, “but they can’t provide medical advice and they can’t prescribe possible treatments,” said one of the panelists, Henry Truong, Chief Technology Officer, Teletech Holdings. Even the data that they provide about a patient’s condition, as rich as it is, can be missing the crucial nuances that a doctor’s eye, or touch, can add.

The roundtable discussion, “The Role of Intelligent Virtual Assistants in Healthcare: How virtual assistants can help solve the ‘adherence gap’ and more,” was led by David Hatch, Senior Vice President for Marketing at EIS. Besides Henry Truong, the panel included Dr. Bruce Metz, Managing Partner, Bruce Metz & Associates; Michael Flammer, Partner, Life Sciences and Healthcare Customer Strategy Services, Teletech Consulting; and Richard Lynch, Vice President and Managing Consultant, Accelare Inc.

Bots are already a key part of the evolution of the digital healthcare ecosystem, said Dr. Metz. “Providers are increasingly getting paid on the quality of outcomes. Meanwhile, consumers are becoming more demanding and discerning. As they pay more, they want more convenient and transparent care.” Enter technology, and with it, “new directions for wellness and disease detection.”

Where bots can be most usefully deployed is in the treatment of chronic illness, which consumes roughly 75% of the $3 trillion spent each year in the United States on healthcare. The next generation of bots, Dr. Metz said, will more fully interact with patients in their homes, featuring such new tools as wifi-enabled pill bottle caps to track the intake of medications. This larger role, akin to “a virtual physician’s assistant,” will result in better chronic disease management.

The bots also provide extraordinary scaling opportunities, Henry Truong noted, allowing providers and payers “in non-homogeneous delivery networks” to share knowledge and increasing the ratio of patients to care-team members “without sacrificing the quality of care.” Bots can’t work alone, however, but rather in “orchestration” with the care team, extending its reach (not just geographically but also into patient lifestyle by monitoring many new things) and increasing its efficiency.

But there are obstacles in the way. For one thing, said Teletech Consulting’s Michael Flammer, 75% of patients are very or somewhat concerned about the privacy of their health records. And those records will be exploding in size. The amount of quantitative data that will be collected by bots is going to be “overwhelming,” Flammer said. Yet from a qualitative standpoint, there will actually be a dearth of information. Is a patient’s skin coloring good? Is the patient depressed? How do those “data points” get collected? Are photos needed, for instance?

From the provider’s point of view, “bots help to close capability gaps,” said Accelare’s Richard Lynch. “They provide new services along the care continuum,” including proactive education and support with financial questions. “They simplify the complexity, and help patients navigate the system.” In fact, he said, “chatbots are not a technology play but rather a business capability tool.”

The challenge, Dr. Metz added, is for regulators and insurers to revise their rules on compliance and reimbursement. They have to catch up to the bots, he said, which are now “way out in front.”

The roundtable featured a real-time survey of the webinar attendees:

Nearly a fifth of the respondents, or 17%, said that bots are a major priority (supported by funding and executive buy-in) and 50% said they are important but still require a business case. The remaining 33% said bots are not a priority at this time.

None of the attendees has been using bots for more than a year, but 14% have recently launched their first wave, another 14% have begun testing in one area, and nearly three-quarters, or 71%, are just starting to investigate how bots can be used.

When asked where they would deploy their first bots, 100% of the participants chose extending patient care remotely. Sixty percent also identified patient or member services.

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